Healthcare Provider Details

I. General information

NPI: 1093457830
Provider Name (Legal Business Name): HORIZON PACE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2028 MERRICK DR
RICHMOND KY
40475-8133
US

IV. Provider business mailing address

PO BOX 572
RICHMOND KY
40476-0572
US

V. Phone/Fax

Practice location:
  • Phone: 859-623-4080
  • Fax: 859-624-5771
Mailing address:
  • Phone: 859-623-4080
  • Fax: 859-624-5771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MARIBETH UPCHURCH
Title or Position: OPERATIONS ASSOCIATE
Credential:
Phone: 859-623-4080